Gastrocnemius - Common Trigger Point Sites
The gastrocnemius is part of the composite muscle known as the triceps surae, which forms the prominent contour of the calf.
The triceps surae comprises the gastrocnemius, soleus, and plantaris. The popliteal fossa at the back of the knee is formed inferiorly by the bellies of the gastrocnemius and plantaris, laterally by the tendon of the biceps femoris, and medially by the tendons of the semimembranosus and semitendinosus.
Trigger points in the gastrocnemius are typically associated with calf pain/stiffness, nocturnal cramps, foot pain (instep), and pain in the back of the knee on mechanical activity.
Assessment of Gastrocnemius
The patient’s left leg is placed across the therapist’s thigh. From this position, the therapist has control of the patient’s left lower limb and foot.
It is important to make sure that the patient’s leg is kept straight at the knee, as this will influence the test result.
The therapist gently encourages the patient’s left ankle into a dorsiflexed position until a bind is felt (see illustration below).
The normal range of motion should achieve 90 degrees; if the point of bind is felt sooner, the gastrocnemius is classified as short.
The therapist gently encourages the patient’s left ankle into a dorsiflexed position until a bind is felt. A range of motion of 90 degrees is normal.
Alternative Method for Testing the Muscle Length of the Gastrocnemius
This test can be performed if the patient has a normal range of motion in their hamstrings; if the hamstrings have been classified as short, the original test described above must be used.
The therapist passively takes the patient’s left leg to 90 degrees of hip flexion. From this position, the therapist controls the patient’s left lower limb and stabilizes the ankle.
The therapist slowly encourages the patient’s ankle into dorsiflexion and feels for a bind (as shown below). If a range of 90 degrees can be achieved with no resistance, the gastrocnemius is classified as normal.
Testing the gastrocnemius: a range of motion of 90 degrees is normal. This technique also gives an indication of hamstring length.
MET Treatment of Gastrocnemius
The patient is asked to push their toes away (plantar flexion) to activate the gastrocnemius (see figures (a) and (c) below).
After a 10-second contraction and on the relaxation phase, the therapist encourages dorsiflexion to promote lengthening of the gastrocnemius (see figures (b) and (d) below).
Figure (a) Contraction of Gastrocnemius
Figure (b) Lengthening of Gastrocnemius
Figure (c) The patient plantar flexes the ankle from 90 degrees of hip flexion
Figure (d) - after the contraction, the therapist encourages dorsiflexion of the ankle to lengthen the gastrocnemius
This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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